59F with 1 week history of fast palpitations and giddiness

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 56 F presented with c/o fast palpitations associted with giddiness and sob on exertion

since 1 week 

on arraival serial ecgs with intervention. 



below ecg is after 6 and 12 mg adenosine 

not reverted to sinus rhythm with adenosine 12mg

patient was started on cardarone infusion 



no much change in rhythm and developed tacchycardia wih frequent long pauses. 





in view of hypotension with long pauses, emergency TPI was done along with CAG. 


next day rhythm reverted to sinus and TPI was removed. 












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